Discipline by State Medical Boards and Others

Disciplinary issues have been among the thorniest facing clinicians, particularly M.D.'s, offering CAM therapies.

While a malpractice lawsuit involves a civil claim by a private party (the patient) against the provider, professional discipline against a CAM provider involves an administrative hearing by a professional regulatory board (for example, the state board of chiropractors but more typically the state medical board).

There may be overlap between the two actions (for example, a common allegation of malpractice), but they are brought by different actors (e.g., the patient in one case; a regulatory board in another) and for different purposes (e.g., to gain monetary compensation in one case, and to evaluate whether the provider should be sanctioned in another).

CAM regulatory boards can impose sanctions similar to the ones medical boards can impose on their licensees, the most serious being the stripping away of a provider's license. One of the most common scenarios, as reported in judicial opinions, involves a CAM provider's conduct exceeding the legislatively authorized scope of practice.

In general, some of the risk management strategies used to help manage or minimize malpractice liability will be useful in reducing risk. It's also a good idea to read your licensing statute and any applicable regulations or cases, and see whether your board has been active in this area. Following the maxim that "the best predictor of the future is the best" (or at least a good predictor), you can see how the board has handled disciplinary cases involving CAM services in the past. Other than the relevant statutes and regulations which may provide written standards, there is not a lot of reliable literature in the area, so here is where hands-on inquiry can be helpful.

For cases involving disciplinary actions against physicians and chiropractors and others, see chapters 4 and 7 in my 1998 book. This also provides a good overview of the issues involved.